Veno-venous extracorporeal membrane oxygenation tracheal sleeve pneumonectomy

Tracheal sleeve pneumonectomy is a complex surgical procedure consisting in removal of the whole lung together with the tracheo-bronchial bifurcation. Airway reconstruction is performed by an end- to-end tracheo bronchial anastomosis usually with cross-field ventilation with or without jet ventilation support. Extracorporeal membrane oxygenator (ECMO) represents an excellent alternative to cross-field ventilation during tracheal sleeve pneumonectomy, providing tissues oxygenation and CO2 removal, without disturbing lines or tubes in the surgical field, when performed with peripheral cannulation. The aim of this paper is to focus on the role of intraoperative ECMO during tracheal sleeve pneumonectomy, indications and contraindications as well as advantages and disadvantages.